Pain physician
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Randomized Controlled Trial
Intravenous Versus Peribulbar Dexmedetomidine as an Adjunct to Local Anesthetics in Strabismus Surgery: A Randomized, Double-blinded Clinical Trial.
Dexmedetomidine has not been adequately studied as an adjuvant to peribulbar anesthesia in strabismus surgery. ⋯ Peribulbar dexmedetomidine outperforms intravenous dexmedetomidine in terms of postoperative analgesia and motor block duration when used as an adjunct to peribulbar anesthesia for strabismus surgery. However, the intravenous group had significantly shorter surgical times.
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Randomized Controlled Trial
Dose Equivalence of Remimazolam and Propofol for Loss of Consciousness in Pediatric Patients: A Randomized Clinical Trial.
Remimazolam and propofol can be used interchangeably for general anesthesia. However, no dosing recommendations exist for the intravenous bolus administration of remimazolam during general anesthesia induction in pediatric patients. Determining the appropriate dose for anesthesia induction in pediatric patients is crucial for safe and effective surgical procedures. ⋯ Remimazolam demonstrates significantly higher sedative efficacy for pediatric patients than does propofol. An induction dose of 0.34 mg/kg-1 remimazolam could be recommended for general anesthesia induction, considering the safety and effectiveness of a 2 mg/kg-1 dose of propofol.
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Comparative Study Observational Study
Comparison of Robot-Assisted and Fluoroscopy-Assisted Percutaneous Kyphoplasty for Bone Cement Distribution and Clinical Efficacy.
The distribution of bone cement after percutaneous kyphoplasty (PKP) affects its clinical efficacy in patients with osteoporosis. Robotic and traditional treatment of osteoporotic vertebral compression fractures (OVCFs) have both been established as effective, but no studies have compared these 2 modalities in terms of bone cement distribution and clinical outcomes. ⋯ Robot-assisted percutaneous kyphoplasty can establish an optimal path via the unipedicular approach, thereby effectively mitigating the potential risks associated with vascular nerve and cortical bone injuries. Additionally, RAUPK ensures a more favorable distribution of bone cement and provides superior pain relief for patients. Furthermore, RAUPK has greater long-term efficacy than does FAUPK.
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Observational Study
A Nomogram Model for Predicting Postherpetic Neuralgia in Patients with Herpes Zoster: A Prospective Study.
Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a negative effect on patients. A simple and practical PHN prediction model is lacking. ⋯ The incidence of PHN is influenced by factors such as being a woman, being more than 50 years old, having prodromal phase pain, having a large rash area, and having great pain severity during the acute stage. The prediction model developed in this study effectively forecasts the occurrence of PHN using these 5 risk factors, making it a valuable tool for clinical practice.
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Discogenic chronic low back pain (cLBP) and radiculopathy are the most prevalent causes of disability worldwide. Older spine treatments often lack reliability and are associated with adverse events. Among surgical treatment options, discectomies weaken discs, and fusions cause direct damage to adjacent discs, so both treatments accelerate disc degeneration. Other regenerative medicine treatments, including "stem cell" (centrifuged bone marrow aspirate, BMC), and platelet-rich plasma (PRP), lack fibrin's bio-adhesive properties. Specifically, fibrin is a strong bio-adhesive, so it immediately integrates into disc defects and binds there, becoming a part of the disc and facilitating new disc tissue growth. ⋯ Intra-annular fibrin bio-adhesive sealant demonstrates the ability to be an effective treatment for alleviating discogenic cLBP and radiculopathy for at least 3 years, even in patients who all failed multiple prior treatments, including discectomy, fusion, disc PRP, or BMC. The results suggest the benefits of fibrin sealant. Future investigations to consider include a randomized double-blind controlled trial and further categorical analyses.